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Sunday, January 17, 2016

MY PROSTATE.

I am here to speak with you on Prostate. The topic is misleading.
Is prostate strictly for men?
Yes, ONLY men have prostate and ONLY men over 40years but the healthcare enlightenment is for everyone. There is no woman who does not know a man 40 years and above – father, uncle, brother, son, friend, neighbor, colleague…. Essentially what I will be doing today is health promotion. Responsible health promotion must provide three things:
1. Information
2. Reassurance
3. A plan of action.
Let me start with a background on prostate health. Everyone has a pair of kidneys. The job of the kidney is to remove waste. It is the LAWMA (waste management company) of your body. Everyday your blood passes through the kidney several times to be filtered. As the blood is filtered, urine is formed and stored in a temporary storage tank called the urinary bladder. If there were to be no urinary bladder, as a man walks on the road, urine will be dropping. Now think of the plumbing work in your house. Think of the urinary bladder as the overhead storage tank. From the storage tank, a good plumber will run pipes to other parts of the house, including the kitchen. God in His wisdom ran pipes from our urinary bladder to the tip of the penis. The pipe is called the urethra. Just below the bladder and surrounding the urethra is a little organ called the prostate gland. The prostate gland is the size of a walnut and weighs about 20grams. Its job is to make the seminal fluid which is stored in the seminal vesicle. During sexual intercourse, seminal fluid comes down the urethra and mixes with the sperms produced in the testicles to form the semen. So semen technically is not sperm. It is sperm + seminal fluid. The seminal fluid lubricates the sperm. After age 40, for reasons that may be hormonal, the prostate gland begins to enlarge. From 20 grams it may grow to almost 100 grams.
As it enlarges, it squeezes the urethra and the man begins to notice changes in the way he urinates. If you have a son under 10, if he has a little mischief like we all did at that age, when he comes out to urinate, he can target the ceiling and the jet will hit target. Call his father to do same, wahala dey. His urine stream is weak, cannot travel a long distance and sometimes may come straight down on his legs. So he may need to stand in awkward position to urinate.
Not many men will be worried their urine stream cannot hit the ceiling. Toilets are on the floor and not on the ceiling. But other symptoms begin to show.

TERMINAL DRIPPLING:
The man begins to notice that after urinating and repacking, urine still drops on his pants. This is the reason why after an older man urinates, he has to ring bell. A younger man simply delivers to the last drop and walks away.
Just see an older man coming from the bathroom. Sometimes he may clutch the newspaper closely to hide the urine stains, particularly on plain colored trousers.

HESISTANCY
At this point you wait longer for the urine flow to start. There are 2 valves that must open for you to urinate – the internal and external sphincters. Both open but because of obstructions in the urethra, you wait long for the flow to start.

INCOMPLETE EMPTYING
You have this feeling immediately after urinating that there is still something left. As all these things happen, the bladder begins to work harder to compensate for the obstruction in the urethra. The frequency of urination goes up. Urgency sets in. sometimes you have to practically run into the toilet. Nocturia also becomes common. You wake up more than 2 times at night to urinate. Your wife begins to complain. Men being men may not talk to anyone even at this point. Then the more serious complications start.
Stored urine gets infected and there may be burning sensation when urinating. Stored urine forms crystals. Crystals come together to form stone either in the bladder or in the kidney. Stones may block the urethra.Chronic urinary retention sets in. The bladder stores more and more urine. The size of the bladder is 40- 60 cl. A bottle of coke is 50cl. As the bladder stores more urine it can enlarge up to 300cl. An overfilled bladder may leak and this leads to wetting / urinary incontinence. Also the volume may put pressure on the kidney and may lead to kidney damage. What may likely bring the man to hospital is acute urinary retention. He wakes up one day and he is not able to pass urine.
Everything I have described above is associated with prostate enlargement, technically called benign prostate hyperplasia. There are other diseases of the prostate like
1. Prostatitis – inflammation of the prostate
2. Prostate cancer – cancer of the prostate.
This discussion is on prostate enlargement. I have bad news and good news. The bad news is that everyman will have prostate enlargement if he lives long enough. The good news is that there are life style changes that can help the man after 40 to maintain optimum prostate health.

Nutrition
Look at what you eat. 33% of all cancers, according to the US National Cancer Institute is related to what we eat. Red meat everyday triples your chances of prostate disease. Milk everyday doubles your risk. Not taking fruits / vegetables daily quadruples your risk. Tomatoes are very good for men. If that is the only thing your wife can present in the evening, eat it with joy. It has loads of lycopene. Lycopene is the most potent natural antioxidant. Foods that are rich in zinc are also good for men. We recommend pumpkin seeds (ugbogulu). Zinc is about the most essential element for male sexuality and fertility. Men need more zinc than women. Every time a man ejaculates he loses 15mg of zinc. Zinc is also important for alcohol metabolism. Your liver needs zinc to metabolize alcohol.

ALCOHOL CONSUMPTION
As men begin to have urinary symptoms associated with prostate enlargement, it is important they look at alcohol consumption. More fluid in means more fluid out Drink less. Drink slowly.

EXERCISE
Exercise helps build the muscle tone. Every man should exercise. Men over 40 should avoid high impact exercise like jogging. It puts pressure on the knees. Cycling is bad news for the prostate. We recommend brisk walking.

SITTING
When we sit, two-third of our weight rests on the pelvic bones. Men who sit longer are more prone to prostate symptoms. Do not sit for long hours. Walk around as often as you can. Sit on comfortable chairs. We recommend a divided saddle chair if you must sit long hours.

DRESSING
Men should avoid tight underwear. It impacts circulation around the groin and heats it up a bit. While the physiological temperature is 37 degrees, the groin has an optimal temperature of about 33 degrees. Pant is a no-no for men. Wear boxers.
Wear breathable clothing.

SMOKING
Avoid smoking. It affects blood vessels and impact circulation around the groin.

SEX
Regular sex is good for the prostate. Celibates are more prone to prostate illness. While celibacy is a moral decision, it is not a biological adaptation. Your prostate gland is to empty its contents regularly.